Healthcare Provider Details
I. General information
NPI: 1063986289
Provider Name (Legal Business Name): PICTURE PERFECT ,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/22/2019
Last Update Date: 10/27/2022
Certification Date: 10/27/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4332 CENTRAL AVE STE M
HOT SPRINGS AR
71913-7255
US
IV. Provider business mailing address
4332 CENTRAL AVE STE M
HOT SPRINGS AR
71913-7255
US
V. Phone/Fax
- Phone: 501-463-9063
- Fax:
- Phone: 501-463-9063
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085U0001X |
| Taxonomy | Diagnostic Ultrasound Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BUDIMIR
RATKOVIC
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 501-463-9063